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- Ensuring that the patients medications and treatments are appropriate for his or her diagnosis
- Working with other members of the interdisciplinary team to provide comprehensive care for the patient
- Contacting the insurance company to facilitate payment for services
- Working with a social worker to make sure the patients family has resources for care
The utilization review nurse's role is designed to ensure that a patient is receiving the necessary treatments and procedures for his or her condition without undergoing any unnecessary therapies. By reviewing these terms, the utilization review nurse saves the healthcare center money by avoiding payments on expensive treatments that are unwarranted. The nurse's role also saves the patient from undergoing possibly painful and expensive tests and procedures that are not needed.
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